Meningococcal disease is an uncommon but potentially life-threatening infection caused by Neisseria meningitidis bacteria. It can present as meningitis or sepsis and progresses rapidly, even in otherwise healthy individuals. Despite advances in care, the case-fatality rate remains 10–15%, and up to 20% of survivors experience long-term complications such as hearing loss, neurologic impairment, or limb loss.
In the United States, disease incidence is low (20–50 cases annually in recent years). However, outbreaks continue to occur particularly among very young children and people ages 16-23 years, and in community settings, such as college campuses. Although there are at least 13 types of Neisseria meningitidis, most serious cases are caused by the A, B, C, W, and Y serogroups. 1
Vaccination is the most effective tool for meningococcal prevention. Two types of vaccines are currently licensed in the U.S.:
Men-ACYW (MenQuadfi® and Menveo®) are composed of capsular polysaccharide conjugated to a protein and cover meningococcal strains A, C, W, and Y.
The Men-ACYW vaccines are recommended for:
Booster guidance: For individuals who remain at ongoing risk, repeat doses may be given every 5 years
MenB vaccines are recommended for:
MenB dosing:
Note: MenB vaccines are not interchangeable. The same product must be used for all doses.
In the first episode of the AAFP’s Leading Edge series, our family physician host Mike Richardson, MD, is joined by Paritosh Kaul, FAAP, FSAHM, a pediatrician and adolescent medicine specialist, to discuss proposed changes to the meningococcal vaccination schedule that the Advisory Committee on Immunization Practices is expected to consider. In their discussion, they review new research, including studies that explore the different vaccination models and the performance of the current vaccination schedule.
Watch the full episode to learn more about how the proposed changes may impact the disease burden and primary care practice.
In this special edition of ‘Inside Family Medicine’, sponsored by Sanofi, Dr. Jana Shaw and Dr. Peter Ziemkowski discuss potential changes to the meningococcal vaccination schedule. Key topics include the current two-dose vaccination schedule, proposed alternative schedules, recent research findings, and the potential implications of schedule changes on public health, health equity, and disease prevention. The episode emphasizes the importance of maintaining the current vaccination schedule for effective disease prevention and highlights the significance of timely vaccinations in protecting adolescents and young adults.
Adolescents/Young Adults:
High-Risk Individuals: Certain groups ≥10 years at increased risk should receive both MenACWY and MenB
MenACWY protects against serogroups A, C, W, and Y and is part of the routine adolescent schedule. MenB protects against serogroup B, which is less common but still causes sporadic cases and outbreaks.
Meningococcal disease remains rare in the U.S., with approximately 20-50 cases reported annually in recent years. But mortality and long-term disability remain high when cases occur. Most cases are sporadic, although small outbreaks still occur — particularly on college campuses.
MenACWY vaccines are proven to be highly effective in preventing disease caused by serogroups A, C, W, and Y. MenB vaccines also protect against serogroup B, but their protection is shorter in duration and antibody levels decline over time, making them most useful during the peak adolescent and young adult risk years. Neither vaccine has been shown to significantly impact carriage or transmission.
Yes. Most side effects are mild and self-limited (injection site pain, headache, fatigue, fever). Serious reactions, including anaphylaxis, are very rare. Long-term safety monitoring has not identified any concerning safety signals.
MenACWY products may be used interchangeably in most situations. However, MenB vaccines are not interchangeable; the series must be completed with the same product.
Meningococcal vaccines should be covered by most commercial and public insurance plans. The Vaccines for Children (VFC) program covers qualified children under the age of 18.
More information is available at:
1. Hambrosky J, Kroger A, Wolfe S, eds. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine Preventable Diseases. 13th ed. Washington, D.C. Public Health Foundation; 2015.
2. Cohn A, MacNeil JR, Clark TA, et al. Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices. MMWR. 2013;62(RR02):1-22.
3. MacNeil J, Rubin L, Temitope F, Ortega-Sanchez I. Use of serogroup B meningococcal vaccines in adolescents and young adults: recommendations of the Advisory Committee on Immunization Practices. MMWR. 2015;64(41):1171-1176.